CoVid19 Part XI - 2,615 in ROI (46 deaths) 410 in NI (21 deaths)(29/03)*OP upd 28/03*

Renjit

Muahahaha wrote: »

12x seems unachievable but 2x must definitely be possible. Its essentially an oxygen pump, if they can double its output then and attach it to two patients rather than one that would be a massive help.

Lots of companies making them but you'd wonder where the software/electronics side is going to come from. On top of that they'd have to be tested and approved for use on humans which takes time. Modifying existing units to pump for two patients would be a much quicker way of solving the problem.

2x should be considered with caution
https://www.asahq.org/about-asa/newsroom/news-releases/2020/03/joint-statement-on-multiple-patients-per-ventilator

Volumes would go to the most compliant lung segments.
Positive end‐expiratory pressure, which is of critical importance in these patients, would be impossible to manage.
Monitoring patients and measuring pulmonary mechanics would be challenging, if not impossible.
Alarm monitoring and management would not be feasible.
Individualized management for clinical improvement or deterioration would be impossible.
In the case of a cardiac arrest, ventilation to all patients would need to be stopped to allow the change to bag ventilation without aerosolizing the virus and exposing healthcare workers. This circumstance also would alter breath delivery dynamics to the other patients.
The added circuit volume defeats the operational self‐test (the test fails). The clinician would be required to operate the ventilator without a successful test, adding to errors in the measurement.
Additional external monitoring would be required. The ventilator monitors the average pressures and volumes.
Even if all patients connected to a single ventilator have the same clinical features at initiation, they could deteriorate and recover at different rates, and distribution of gas to each patient would be unequal and unmonitored. The sickest patient would get the smallest tidal volume and the improving patient would get the largest tidal volume.
The greatest risks occur with sudden deterioration of a single patient (e.g., pneumothorax, kinked endotracheal tube), with the balance of ventilation distributed to the other patients.
Finally, there are ethical issues. If the ventilator can be lifesaving for a single individual, using it on more than one patient at a time risks life‐threatening treatment failure for all of them.

fryup

Kermit.de.frog wrote: »

10,000+ deaths in the space of 60 days.

that's chilling

Muahahaha

Blueshoe wrote: »

It's either Trump or Boris. That's all that we hear

Trump has come out and said he "might" place three states including New York into quarantine. Wtf was he doing thinking out loud before an official announcement. Millions of people in NY right now must be thinking of scrambling out of there before the quarantine begins. The wealthiest of them cant even shout 'To the Hamptons!' because thats within NY state :pac:

branie2

Northern Ireland under lockdown now

johnfás

Muahahaha wrote: »

12x seems unachievable but 2x must definitely be possible. Its essentially an oxygen pump, if they can double its output then and attach it to two patients rather than one that would be a massive help.

Lots of companies making them but you'd wonder where the software/electronics side is going to come from. On top of that they'd have to be tested and approved for use on humans which takes time. Modifying existing units to pump for two patients would be a much quicker way of solving the problem.

Licensing existing IP so that others can manufacture already approved designs would presumably be the quickest ...

fr336

Lavinia wrote: »

yes but if you look at stats of closed cases you will see that 45 percent of people died while only 55 percent recovered..


that scares me tbh..

Yeah but is that more from when there were fewer cases? As the cases go up (obviously we don't want them to, but they will and are), will that death rate not stabilise drastically? Ie the overwhelming majority of cases will be mild.

cloudatlas

jackboy wrote: »

Well he is a failed diplomat then. He was clearly speaking for China. He could have just said ‘no comment’ or ‘I’m not answering that question’..

He tried, he even ended the call but she persisted, bad journalism.

Un1corn

cameramonkey wrote: »

Do you believe that the WHO and China are conspiring to hide the true figue of infections in China at the moment?

I cannot speak for the WHO but I believe China has great motivation to do so. Whether they are or not we will never know or be able to verify given the nature of China. When I look at the trends from China and the trajectory in other countries I think China's statistics are highly suspect. I don't believe the WHO is in the position to verify China's numbers are true or false.

Did you check the links earlier about the number of Urns being sent to Wuhan for example?

Spanish Eyes

I hate to say it, but Johnson will be hailed for Brexit now.

EU is not cohesive in the struggle with this virus, although I understand they don't have an over arching Health Brief for all members either.

But still, one voice from the EU Parliament/Commission might have helped. Every country for itself now, and Netherlands and Germany (maybe others too) are opposed to Corona bonds too. Not good.

igCorcaigh

Kermit.de.frog wrote: »

What Johnson will tell the British public...

He never instills faith, does he. We sought, we tried etc.

Lavinia

fr336 wrote: »

Yeah but is that more from when there were fewer cases? As the cases go up (obviously we don't want them to, but they will and are), will that death rate not stabilise drastically? Ie the overwhelming majority of cases will be mild.

we can only hope so, time will tell

Muahahaha

jesus_thats_gre wrote: »

Think there is concerns about cross contamination between air flows. Think I saw something too about how components deteriorate with use.

yeah theres definitely challenges. Not insurmountable though. And it might get to the point that a low risk of cross contamination is preferable to running out of ventilators completely. Its already happened to Italy so the problem is coming down the tracks for all health services.

Kermit.de.frog

kilkenny31 wrote: »

Just for the sake of comparison how does that compare to a bad flu season?

Differences appear really stark.

See here about recent flu outbreak


https://www.thelocal.it/20200123/flu-outbreak-in-italy-half-a-million-people-struck-down-in-a-week

Since the start of flu season in October 2019, 2,768,000 cases across the country have been confirmed by laboratory tests, according to data from InfluNet published on January 19.

A total of 488,000 cases were reported last week alone, signalling that flu season is hitting its peak in January as predicted.

240 deaths have so far been reported, slightly lower than the expected 258. Most of the fatal cases are elderly patients who suffered complications after contracting the virus.

Influenza, commonly called the flu, is a viral infection that attacks your respiratory system.

Blaze420

Spanish Eyes wrote: »

I hate to say it, but Johnson will be hailed for Brexit now.

EU is not cohesive in the struggle with this virus, although I understand they don't have an over arching Health Brief for all members either.

But still, one voice from the EU Parliament/Commission might have helped. Every country for itself now, and Netherlands and Germany (maybe others too) are opposed to Corona bonds too. Not good.

He has nothing to be hailed for, his bull**** approach to this is going to cost thousands of lives. Way too little and way too late. At least he isn’t trump - it takes some doing to doom a population to more deaths than they suffered in WWII but the orange retard has that well sown up already

1800_Ladladlad

FVP3 wrote: »

One factory. It's interesting how the US media, particularly the b media, controls the narrative. I've seen these reports turn up today on a number of sites, here and reddit by right wingers.

Clearly there's an agenda

Fuggin hell

igCorcaigh

fr336 wrote: »

Yeah but is that more from when there were fewer cases? As the cases go up (obviously we don't want them to, but they will and are), will that death rate not stabilise drastically? Ie the overwhelming majority of cases will be mild.

It has been rising recently. Started high, reduced a lot, then a steady rise in the past week or so. Just going by memory, but have a look at the graph.

runawaybishop

irishgeo wrote: »

ring the local station, the guards will be on it. They are endangering the safety of others.

Update, rang the gardai about the group of people fishing beside me, no sign of the gardai after 5 hours. Last car just gone.

Wibbs

Muahahaha wrote: »

12x seems unachievable but 2x must definitely be possible. Its essentially an oxygen pump, if they can double its output then and attach it to two patients rather than one that would be a massive help.

The problem is M, the two patients must require essentially the same ventilator output. I can see it working in patients that "just" require extra oxygen to get them over the hump(like those "helmets" the Italians have stalled giving to us), but not people sedated, muscles paralysed and intubated attached to a ventilator breathing for them.

tony1980

Muahahaha wrote: »

Trump has come out and said he "might" place three states including New York into quarantine. Wtf was he doing thinking out loud before an official announcement. Millions of people in NY right now must be thinking of scrambling out of there before the quarantine begins. The wealthiest of them cant even shout 'To the Hamptons!' because thats within NY state :pac:

Have a client in the Hamptons. Their families in NY have already left last week to go to the Hamptons. I’d say a lot more will try do the same now.

cameramonkey

Un1corn wrote: »

I cannot speak for the WHO but I believe China has great motivation to do so. Whether they are or not we will never know or be able to verify given the nature of China. When I look at the trends from China and the trajectory in other countries I think China's statistics are highly suspect. I don't believe the WHO is in the position to verify China's numbers are true or false.

Did you check the links earlier about the number of Urns being sent to Wuhan for example?

What evidence do you have for your belief that WHO is not in a position to
verify China's numbers?

I have looked for any evidence that WHO think they are being hoodwinked, I have found none but you I suppose know better.Can you post a link to support such a proposition.

niallo27

runawaybishop wrote: »

Update, rang the gardai about the group of people fishing beside me, no sign of the gardai after 5 hours. Last car just gone.

They have no power to do anything yet, it was reported on the news.

coastwatch

Anita Blow wrote: »

You're largely correct. More severe cases of COVID cause myocardial injury- we do Troponins on covid patients (Troponin being a biomarker we use for heart injury in heart attacks, for example) as a predictor of severity.

It's probably not the main reason for death- death will be multi-factorial and this cardiac injury will be just one contributory factor!

Can I ask, are you working on the frontline in Ireland?

Muahahaha

Northern Ireland has clamped down and they are pretty much alligned with our own lockdown now. Thats a good thing because the Brexit mess has shown us that 50,000 people cross the border every day for work

jesus_thats_gre

Kermit.de.frog wrote: »

Differences appear really stark.

See here about recent flu outbreak


https://www.thelocal.it/20200123/flu-outbreak-in-italy-half-a-million-people-struck-down-in-a-week

https://ourworldindata.org/coronavirus

JP Liz V1

Princess Maria Teresa de Borbón-Parma has become the first member of a royal family to pass away

Spanish Eyes

Blaze420 wrote: »

He has nothing to be hailed for, his bull**** approach to this is going to cost thousands of lives. Way too little and way too late. At least he isn’t trump - it takes some doing to doom a population to more deaths than they suffered in WWII but the orange retard has that well sown up already

I was referring to Johnson's Brexit stance and the fact that EU has not worked together on this. YET.

Yes he is a lazy ignorant oaf, and even looks a bit like Trump.

Sorry to say it, but I really did wonder if he actually has CV, or is he just spoofing since he is a lazy lying fecker and might have discovered that the reality of being PM in UK requires hard work and committment. Dunno, still open minded on it TBH.

I would not give Trump any of my bandwidth.

DisneyLover

Lavinia wrote: »

this is so accurate lol

not sure we passed the bargaining phase fully though just yet..

who are we breaking up with thats the breakup steps right!! lol

Talisman

Anita Blow wrote: »

Unlikely to be the reason.

Smoking rates are higher in males and this is a respiratory illness. Men are also more likely to be overweight.
These are just two risk factors for respiratory illness that place men at higher risk.

The same thing has been observed in studies of SARS and MERS.

Do men have a higher case fatality rate of severe acute respiratory syndrome than women do?

Thus, among SARS patients, males may be more severely affected by the disease than females are. This finding could be related to a nonuniform case definition of SARS disease, a different treatment regimen, a past smoking history, work-environment factors, or gender-specific immune-defense factors, for instance.

Current epidemiological status of Middle East respiratory syndrome coronavirus in the world from 1.1.2017 to 17.1.2018: a cross-sectional study

A total of 229 MERS-CoV cases, including 70 deaths (30.5%), were recorded in the disease outbreak news on world health organization website over the study period. Based on available details in this study, the case fatality rate in both genders was 30.5% (70/229) [32.1% (55/171) for males and 25.8% (15/58) for females]. The disease occurrence was higher among men [171 cases (74.7%)] than women [58 cases (25.3%)].

Of course some scientists would be crazy enough to try and replicate the findings using mice:

Sex-based differences in susceptibility to SARS-CoV infection

Our results showed that male mice were more susceptible to SARS-CoV infection compared to age matched females.

In general, males generate less robust immune responses and are more susceptible to a variety of infectious agents. In contrast, females mount stronger innate and adaptive immune responses and are relatively resistant to virus infections.

They went a bit further with their experiment and discovered that when the female's estrogen levels were reduced, their susceptibility to infection increased.

The link with estrogen has been found with other studies also:
Estrogenic compounds reduce influenza A virus replication in primary human nasal epithelial cells derived from female, but not male, donors

The severity of influenza and other respiratory diseases changes over the life course and during pregnancy in women, suggesting that sex steroid hormones, such as estrogens, may be involved.

bekker

jesus_thats_gre wrote: »

Loads of stuff online.

Cuomo talked about it last night. Trialling a 2x configuration. But seen stuff online with up to a 12x split. Musk even inputting into some of the dicussions.

There is also a huge open source Ventilator scene that has spawned in recent weeks - large one here https://opensourceventilator.ie/

Same with Helmet CPAP,

Why can't HSE just issue necessary critical parameters from units they have (volumetric capacity of helmet and optimum seal diameter) out to industry, get out of the way, and let the people who know how to collaborate come up with a workable design that can be indigenously produced, if necessary across multiple shops.

Critical element appears to be neck seal.

Chasing after existing product in competition with bigger clout, pockets and national interest, is probably a lost cause. Same goes for ventilators which are more complex and less easy to re-engineer. But thinking outside the box may allow repurposing and adapting analogous equipment.

If it's a question of being put on one's side to die or using unapproved but working equipment, it's a no-brainer.

jackboy

runawaybishop wrote: »

Update, rang the gardai about the group of people fishing beside me, no sign of the gardai after 5 hours. Last car just gone.

They probably thought you were taking the piss, or a crank. They have better things to be doing.

niallo27

JP Liz V1 wrote: »

Princess Maria Teresa de Borbón-Parma has become the first member of a royal family to pass away

Thsts some name.

kilkenny31

Kermit.de.frog wrote: »

Differences appear really stark.

See here about recent flu outbreak


https://www.thelocal.it/20200123/flu-outbreak-in-italy-half-a-million-people-struck-down-in-a-week

Interesing. That's deaths in a week is it? Which flu season had over 1000 deaths in Ireland? It would be interesting to know. One thing Ive been wondering about is, are the complications of flu the same as COVID-19 like do most people who die of it end up in ICU on ventilators or does it have different complications ie cause organ failure etc.

Blaze420

jackboy wrote: »

They probably thought you were taking the piss, or a crank. They have better things to be doing.

No they don’t - what’s more important than breaking up groups with the potential to spread Covid - catching out of date tax discs on the roads? If they want us to follow the new restrictions then they would be better off showing us they will enforce them, it’s pointless otherwise

cnocbui

Muahahaha wrote: »

Very true, 20,000 die of starvation every single day and the world doesnt even blink



I watched that video a few days ago. Ive so much respect for Bill Gates. He was once the worlds richest man and he could be retired sitting on a $500m super yacht in the Caribbean enjoying his senior years. But instead he has reinvented himself as a major advocate of public health for the worlds poorest people and is going to see out his life donating his vast fortune towards solving problems like malaria and polio.

...

I have admiration for Gates, but he isn't spending his fortune on the world's poor. It seems most likely he spends some of the income from his investments on philanthropy, which is still admirable. His net worth in 2019 was estimated to be $96.5 Billion. In 2010 it was $53 Billion, so he hasn't started spending down his fortune yet, if he ever does.

He's an investor shark, not a fluffy kitten. When Ireland was on it's financial knees, Gates stuck his nose in the trough to feed on our pain.

Last week, Gates regained his crown as the world's richest man, according to the Bloomberg Billionaires index, which pegged his wealth at $78.5bn (€57.4bn), up $15.8bn in the last year.

The Bill & Melinda Gates Foundation owns nearly $20m worth of Irish bonds.

At the end of December 2012, it held close to $7.8m worth of Irish 5.4 government bonds with a maturity of 2025, $6.03m worth of Irish 5 government bonds with a maturity of 2020, and $4.14m worth of Irish 4.5 bonds with a maturity of 2020.

Those bonds have been a spectacular investment, returning close to 10 per cent over the last year.

Irish bonds were the second-best performing government debt in the Bloomberg World Bond Index for 2013, generating returns of close to 12 per cent for investors. That was only topped by Greek bonds, which saw a 47 per cent return for investors.

Giant US investor Franklin Templeton and its star trader, Michael Hasenstab, made a huge bet on the Irish recovery, buying up close to €9bn in Irish bonds. Along with Gates, Franklin Templeton is sitting on vast profits.

The Gates investment in Irish government bonds is bigger than its holdings in gilts from other countries, as his foundation lists a $14.5m holding in British government bonds, over $12m in French bonds, $4m in Swedish government bonds and $12.7m in New Zealand government bonds.

So he's got great publicity and still has a vast mountain of money.

Anita Blow

coastwatch wrote: »

Can I ask, are you working on the frontline in Ireland?

I'm a doctor in Dublin

Hobgoblin11

How do you quarantine NY? Do you switch off wall street?

Daz_

jackboy wrote: »

They probably thought you were taking the piss, or a crank. They have better things to be doing.

Better things to do rather than enforce a stay at home order in a national health emergency ? Right .

Hobgoblin11

This virus could have been genetically engineered by China in Wuhan in order to deny Trump another 4 years in office! Disgrace!

Un1corn

cameramonkey wrote: »

What evidence do you have for your belief that WHO is not in a position to
verify China's numbers?

I have looked for any evidence that WHO think they are being hoodwinked, I have found none but you I suppose know better.Can you post a link to support such a proposition.

The WHO have to go on the basis of the numbers that China gives them. They have no way to verify it independently. I didn't say they are being hoodwinked. I said they are not in a position to very Chinese statistics. Nobody is. It is a closed, intransparent and secretive system and international organizations, for example the WHO, will not be given access to anything the Chinese don't want them to see.

The WHO also are not politically independent and needs to keep the Chinese authorities satisfied. I have no idea why but they are walking on eggshells with China. This isn't about the numbers but for example, they don't allow Taiwan membership of their organization for fear of upsetting China. Look at this interview of a Taiwanese journalist questioning a WHO official gets shut down and he avoids answering the question.

https://youtu.be/tCFPFWsIPmM

He clearly does not want to upset China for some reason. Challenging their numbers would surely upset them also.

This link is better. They call him back and he worms his way out of offending China. They are under the thumb:
https://www.reddit.com/r/China/comments/fqjkab/hk_journalist_asks_who_senior_advisor_about/?utm_source=share&utm_medium=web2x

runawaybishop

niallo27 wrote: »

They have no power to do anything yet, it was reported on the news.

That's not what they said when I rang? Anyway tomorrow if there are more people on my land I will deal with it myself.

jackboy

Blaze420 wrote: »

No they don’t - what’s more important than breaking up groups with the potential to spread Covid - catching out of date tax discs on the roads? If they want us to follow the new restrictions then they would be better off showing us they will enforce them, it’s pointless otherwise

A few lads fishing in the middle of nowhere. There were long queues to get into supermarkets today. Going after the fishermen would absolutely be a waste of resources.

Daz_

jackboy wrote: »

A few lads fishing in the middle of nowhere. There were long queues to get into supermarkets today. Going after the fishermen would absolutely be a waste of resources.

Are fishermen somehow immune from spreading Covid 19 ? I didn’t know that .

bekker

johnfás wrote: »

Licensing existing IP so that others can manufacture already approved designs would presumably be the quickest ...

Licencing could/would be extortionate, check out what happened when Italian 3-D printing guys developed a unavaile replacement part.
Hit with cease and desist lawsuit, profit margin on the part was apparently in the '000s percent of mfrg cost.

Not uncommon in medical equipment, not unjustified recoupment in some cases, but mostly down to the ridiculously lax US Patent Office.

jackboy

Daz_ wrote: »

Are fishermen somehow immune from spreading Covid 19 ? I didn’t know that .

Are long queues of shoppers immune?

caveat emptor

Nesta99 wrote: »

True, I have a blisters on the bridge of my nose and behind my ears.

I am not saying that people shouldnt wear masks, what I am concerned about is that people who wouldnt be familiar with the additional care that is needed to truly mitigate against the spread could actually increase risk. I also feel that mixed messages, officially or via fora like this also is a potential issue tbh. So with that in mind I offer guided opinion and would not claim absolute fact on any of this.

The consideration of supply of masks, and the hike in cost is something that bothers me as if somebody is ponying up €'s rather than cents for disposable masks then they will be reused rather than discarded.

During the H1N1 episode all frontline NHS staff were fitted with respirator type masks and given a supply of filters. Occupational health had us wear the masks, put 'canopy' over our head and pumped really obnoxious smelling gas in to the free space - if you got a whiff of anything then the mask was refitted. In some cases a mould of the lower face was taken if the genericly fitting ones didnt suit an individual. If everyone, especially in healthcare, were fitted with these it would certainly reduce the level of attrition (imo). Cost, supply, policy and subsequent time dealy means this hasnt happened (NHS) on this occasion. They were also reasonably comfortable to wear and visors could be clipped on and not perched on yer nose. Better and more effective all round!! I still have it so could post a pic if ye think it necessary as an example.

Full face visors will protect from direct particles from a cough and also prevent face touching. These would be of greater use to the general public also i believe than disposable masks. Dispoable masks have a lifespan in terms of microparticles of no more than 5 minutes (if they had in the first place even) - certainly the ones that are used as standard are damp and pretty rank after wearing one for any considerable length of time, from vapour in breathing or sweat or both. Evidence based research has shown that they dont make a sinificant difference to most patients in the clinical enviornment in terms of reducing post-op infection. For this reason many Operating Theatre staff opt not to wear them, at their own risk possibly but their non use can help improve communication, reduce costs among other things.

Anything that improves peoples wellbeing at the moment in psychological terms is not a bad thing but only with proper use that wont potentially exacerbate infection rates through misuse, complacency etc.

Of course this is all a very fluid situation so things change daily and it might very well be decided that the benefits outweigh the risk but at the moment I dont believe this is the case. When you see people wearing masks that are for dust particulate like those used on construction sites its is apparent that people dont rally understand the appropriate use in terms of preventing microorganism spread.

Im not sure if it is the time to really debate the pros and cons of disposable masks but there does need to be greater awareness of the potential pitfalls at the same time. Maybe that is to come as only so much information can be doled out before information fatigue kicks in.

As I said in my previous post, its my pennys worth - not a sort of dictat or rolling of eyes at those who do chose to wear masks etc.

(I wont go digging out the back up to this so I waill say that anecdotally Ebola infects less people who are in contact and Hazmat suits would be worn - of course the mortality rate is higher but they really are the only level of PPE that would be thorough but of course would be impractical on almost every level).

Thanks for the reply. I don't have any experience with using masks. This is a a pandemic and last time anybody had any experience of something similar was over 100 years ago.

The science is quite clear on how masks help stop the transmission. I don't like being fed horse**** because our leaders didn't have the foresight to prepare. I get there is a shortage an we must deal with that. Particularly for those most effected (health care workers).

People may already have purchased masks and might not wear them because of the government mixed messages. We have a disproportionate amount of health care workers who are getting sick compared to other countries.

This is airborne. That's the reality at this stage. Face guards are great but won't help you if you are in an high risk environment where people are coughing etc.

I take your argument that single use PPE should not be reused. This is life and death for our HCW. Innovative solutions should be forth coming in this time of crisis. There are other forms of respirators which can be reused.

This is a classic "there's nothing we could have done". My point is there is clearly something they could have done to prepare for this however unlikely.

Beasty

smelly sock wrote: »

Do people still put the clocks forward?

Seriously. Most do it automatically.

It's easy in the autumn - just don't bother winding it up and let it stop for an hour. Spring is a bit more of a rigmarole though, and avoiding messing up the day/date is a real PITA

runawaybishop

jackboy wrote: »

A few lads fishing in the middle of nowhere. There were long queues to get into supermarkets today. Going after the fishermen would absolutely be a waste of resources.

People are allowed to queue for shopping, they are not allowed fish on my land in groups and have chats in the car park. Maybe it is a waste of resources though, just annoyed the gardai said they would come out and then not show up.

Blaze420

jackboy wrote: »

A few lads fishing in the middle of nowhere. There were long queues to get into supermarkets today. Going after the fishermen would absolutely be a waste of resources.

Did you not see the message the last few weeks? STAY THE **** AT HOME. What part of fishing in the middle of nowhere is following that advice?

runawaybishop

jackboy wrote: »

A few lads fishing in the middle of nowhere. There were long queues to get into supermarkets today. Going after the fishermen would absolutely be a waste of resources.

People are allowed to queue for shopping, they are not allowed fish on my land in groups and have chats in the car park. Maybe it is a waste of resources though, just annoyed the gardai said they would come out and then not show up.

Daz_

jackboy wrote: »

Are long queues of shoppers immune?

People shopping for food - a necessity
Lads out fishing for the sport of it - clowns